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Abstract
Background The Informed Health Choices (IHC) Key Concepts is a framework that provides a basis for developing educational resources and evaluating people's ability to think critically about health actions. We developed the original Key Concepts framework by reviewing texts and checklists for the public, journalists, and health professionals and collecting structured feedback from an international advisory group. We revised the original 2015 framework yearly from 2016 to 2018 based on feedback and experience using the framework. The objectives of this paper are to describe the development of the framework since 2018 and summarise their basis. Methods For the 2019 version, we responded to feedback on the 2018 version. For the current 2022 version, in addition to responding to feedback on the 2019 version, we reviewed the evidence base for each of the concepts. Whenever possible, we referenced systematic reviews that provide a basis for a concept. We screened all Cochrane methodology reviews and searched Epistemonikos, PubMed, and Google Scholar for methodology reviews and meta-epidemiological studies. Results The original framework included 32 concepts in six groups. The 2019 version and the current 2022 version include 49 concepts in the same three main groups that we have used since 2016. There are now 10 subgroups or higher-level concepts. For each concept, there is an explanation including one or more examples, the basis for the concept, and implications. Over 600 references are cited that support the concepts, and over half of the references are systematic reviews. Conclusions There is a large body of evidence that supports the IHC key concepts and we have received few suggestions for changes since 2019.
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Affiliation(s)
- Andrew D. Oxman
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Iain Chalmers
- Centre for Evidence-Based Medicine, Department of Primary Care, University of Oxford, Oxford, UK
| | - Astrid Dahlgren
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Riera R, de Oliveira Cruz Latorraca C, Padovez RCM, Pacheco RL, Romão DMM, Barreto JOM, Machado MLT, Gomes R, da Silva SF, Martimbianco ALC. Strategies for communicating scientific evidence on healthcare to managers and the population: a scoping review. Health Res Policy Syst 2023; 21:71. [PMID: 37430348 DOI: 10.1186/s12961-023-01017-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Health evidence needs to be communicated and disseminated in a manner that is clearly understood by decision-makers. As an inherent component of health knowledge translation, communicating results of scientific studies, effects of interventions and health risk estimates, in addition to understanding key concepts of clinical epidemiology and interpreting evidence, represent a set of essential instruments to reduce the gap between science and practice. The advancement of digital and social media has reshaped the concept of health communication, introducing new, direct and powerful communication platforms and gateways between researchers and the public. The objective of this scoping review was to identify strategies for communicating scientific evidence in healthcare to managers and/or population. METHODS We searched Cochrane Library, Embase®, MEDLINE® and other six electronic databases, in addition to grey literature, relevant websites from related organizations for studies, documents or reports published from 2000, addressing any strategy for communicating scientific evidence on healthcare to managers and/or population. RESULTS Our search identified 24 598 unique records, of which 80 met the inclusion criteria and addressed 78 strategies. Most strategies focused on risk and benefit communication in health, were presented by textual format and had been implemented and somehow evaluated. Among the strategies evaluated and appearing to yield some benefit are (i) risk/benefit communication: natural frequencies instead of percentages, absolute risk instead relative risk and number needed to treat, numerical instead nominal communication, mortality instead survival; negative or loss content appear to be more effective than positive or gain content; (ii) evidence synthesis: plain languages summaries to communicate the results of Cochrane reviews to the community were perceived as more reliable, easier to find and understand, and better to support decisions than the original summaries; (iii) teaching/learning: the Informed Health Choices resources seem to be effective for improving critical thinking skills. CONCLUSION Our findings contribute to both the knowledge translation process by identifying communication strategies with potential for immediate implementation and to future research by recognizing the need to evaluate the clinical and social impact of other strategies to support evidence-informed policies. Trial registration protocol is prospectively available in MedArxiv (doi.org/10.1101/2021.11.04.21265922).
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Affiliation(s)
- Rachel Riera
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Carolina de Oliveira Cruz Latorraca
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | | | - Rafael Leite Pacheco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil.
- Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.
| | - Davi Mamblona Marques Romão
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Instituto Veredas, São Paulo, Brazil
| | - Jorge Otávio Maia Barreto
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | - Maria Lúcia Teixeira Machado
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Federal de São Carlos, São Carlos, Brazil
| | - Romeu Gomes
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Fundação Oswaldo Cruz, Brasília, Brazil
| | | | - Ana Luiza Cabrera Martimbianco
- Hospital Sírio-Libanês, Rua Barata Ribeiro, 142, 2O andar, São Paulo, SP, 01308-000, Brazil
- Universidade Metropolitna de Santo (Unimes), Santos, Brazil
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Deliv C, Devane D, Putnam E, Healy P, Hall A, Rosenbaum S, Toomey E. Development of a video-based evidence synthesis knowledge translation resource: Drawing on a user-centred design approach. Digit Health 2023; 9:20552076231170696. [PMID: 37152241 PMCID: PMC10159242 DOI: 10.1177/20552076231170696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Objectives We aimed to develop a video animation knowledge translation (KT) resource to explain the purpose, use and importance of evidence synthesis to the public regarding healthcare decision-making. Methods We drew on a user-centred design approach to develop a spoken animated video (SAV) by conducting two cycles of idea generation, prototyping, user testing, analysis, and refinement. Six researchers identified the initial key messages of the SAV and informed the first draft of the storyboard and script. Seven members of the public provided input on this draft and the key messages through think-aloud interviews, which we used to develop an SAV prototype. Seven additional members of the public participated in think-aloud interviews while watching the video prototype. All members of the public also completed a questionnaire on perceived usefulness, desirability, clarity and credibility. We subsequently synthesised all data to develop the final SAV. Results Researchers identified the initial key messages as 1) the importance of evidence synthesis, 2) what an evidence synthesis is and 3) how evidence synthesis can impact healthcare decision-making. Members of the public rated the initial video prototype as 9/10 for usefulness, 8/10 for desirability, 8/10 for clarity and 9/10 for credibility. Using their guidance and feedback, we produced a three-and-a-half-minute video animation. The video was uploaded on YouTube, has since been translated into two languages, and viewed over 12,000 times to date. Conclusions Drawing on user-centred design methods provided a structured and transparent approach to the development of our SAV. Involving members of the public enhanced the credibility and usefulness of the resource. Future work could explore involving the public from the outset to identify key messages in developing KT resources explaining methodological topics. This study describes the systematic development of a KT resource with limited resources and provides transferrable learnings for others wishing to do similar.
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Affiliation(s)
- Cristian Deliv
- School of Medicine, University of Galway, Galway, Ireland
| | - Declan Devane
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - El Putnam
- School of English and Creative Arts, University of Galway, Galway, Ireland
| | - Patricia Healy
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Amanda Hall
- Primary Healthcare Research Unit,
Faculty of Medicine, Memorial University,
Newfoundland, Canada
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public
Health, Oslo, Norway
| | - Elaine Toomey
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evid Based Med 2021; 26:234-236. [PMID: 33158855 PMCID: PMC8479747 DOI: 10.1136/bmjebm-2020-111390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Matt Oxman
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Laurence Habib
- Department of Computer Science, Oslo Metropolitan University, Oslo, Norway
| | - Gro Jamtvedt
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Bente Kalsnes
- Department of Communication, Kristiania University College, Oslo, Norway
| | - Marianne Molin
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Department of Health, Bjorknes University College, Oslo, Norway
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Nsangi A, Semakula D, Rosenbaum SE, Oxman AD, Oxman M, Morelli A, Austvoll-Dahlgren A, Kaseje M, Mugisha M, Uwitonze AM, Glenton C, Lewin S, Fretheim A, Sewankambo NK. Development of the informed health choices resources in four countries to teach primary school children to assess claims about treatment effects: a qualitative study employing a user-centred approach. Pilot Feasibility Stud 2020; 6:18. [PMID: 32055405 PMCID: PMC7008535 DOI: 10.1186/s40814-020-00565-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/31/2020] [Indexed: 11/10/2022] Open
Abstract
Background People of all ages are flooded with health claims about treatment effects (benefits and harms of treatments). Many of these are not reliable, and many people lack skills to assess their reliability. Primary school is the ideal time to begin to teach these skills, to lay a foundation for continued learning and enable children to make well-informed health choices, as they grow older. However, these skills are rarely being taught and yet there are no rigorously developed and evaluated resources for teaching these skills. Objectives To develop the Informed Health Choices (IHC) resources (for learning and teaching people to assess claims about the effects of treatments) for primary school children and teachers. Methods We prototyped, piloted, and user-tested resources in four settings that included Uganda, Kenya, Rwanda, and Norway. We employed a user-centred approach to designing IHC resources which entailed multiple iterative cycles of development (determining content scope, generating ideas, prototyping, testing, analysing and refining) based on continuous close collaboration with teachers and children. Results We identified 24 Key Concepts that are important for children to learn. We developed a comic book and a separate exercise book to introduce and explain the Key Concepts to the children, combining lessons with exercises and classroom activities. We developed a teachers' guide to supplement the resources for children. Conclusion By employing a user-centred approach to designing resources to teach primary children to think critically about treatment claims and choices, we developed learning resources that end users experienced as useful, easy to use and well-suited to use in diverse classroom settings.
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Affiliation(s)
- Allen Nsangi
- 1College of Health Sciences, Makerere University, Kampala, Uganda.,2University of Oslo, Oslo, Norway
| | - Daniel Semakula
- 1College of Health Sciences, Makerere University, Kampala, Uganda.,2University of Oslo, Oslo, Norway
| | - Sarah E Rosenbaum
- 3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Andrew David Oxman
- 2University of Oslo, Oslo, Norway.,3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Matt Oxman
- 3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | | | - Astrid Austvoll-Dahlgren
- 3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | | | | | | | - Claire Glenton
- 3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Simon Lewin
- 3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway.,7Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Atle Fretheim
- 2University of Oslo, Oslo, Norway.,3Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
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Semakula D, Nsangi A, Oxman AD, Oxman M, Austvoll-Dahlgren A, Rosenbaum S, Morelli A, Glenton C, Lewin S, Nyirazinyoye L, Kaseje M, Chalmers I, Fretheim A, Rose CJ, Sewankambo NK. Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about treatment effects: one-year follow up of a randomised trial. Trials 2020; 21:187. [PMID: 32059694 PMCID: PMC7023790 DOI: 10.1186/s13063-020-4093-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/18/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Earlier, we designed and evaluated an educational mass media intervention for improving people's ability to think more critically and to assess the trustworthiness of claims (assertions) about the benefits and harms (effects) of treatments. The overall aims of this follow-up study were to evaluate the impact of our intervention 1 year after it was administered, and to assess retention of learning and behaviour regarding claims about treatments. METHODS We randomly allocated consenting parents to listen to either the Informed Health Choices podcast (intervention) or typical public service announcements about health issues (control) over 7-10 weeks. Each intervention episode explained how the trustworthiness of treatment claims can be assessed by using relevant key concepts of evidence-informed decision-making. Participants listened to two episodes per week, delivered by research assistants. We evaluated outcomes immediately, and a year after the intervention. Primary outcomes were mean score and the proportion with a score indicating a basic ability to apply the key concepts (> 11 out of 18 correct answers) on a tool measuring people's ability to critically appraise the trustworthiness of treatment claims. Skills decay/retention was estimated by calculating the relative difference between the follow-up and initial results in the intervention group, adjusting for chance. Statistical analyses were performed using R (R Core Team, Vienna, Austria; version 3.4.3). RESULTS After 1 year, the mean score for parents in the intervention group was 58.9% correct answers, compared to 52.6% in the control (adjusted mean difference of 6.7% (95% CI 3.3% to 10.1%)). In the intervention group, 47.2% of 267 parents had a score indicating a basic ability to assess treatment claims compared to 39.5% of 256 parents in the control (adjusted difference of 9.8% more parents (95% CI 0.9% to 18.9%). These represent relative reductions of 29% in the mean scores and 33% in the proportion of parents with a score indicating a basic ability to assess the trustworthiness of claims about treatment effects. CONCLUSIONS Although listening to the Informed Health Choices podcast initially led to a large improvement in the ability of parents to assess claims about the effects of treatments, our findings show that these skills decreased substantially over 1 year. More active practice could address the substantial skills decay observed over 1 year. TRIAL REGISTRATION Pan African Clinical Trial Registry (www.pactr.org), PACTR201606001676150. Registered on 12 June 2016.
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Affiliation(s)
- Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Andrew D. Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Astrid Austvoll-Dahlgren
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | | | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Laetitia Nyirazinyoye
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | - Atle Fretheim
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
| | - Christopher J. Rose
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213 Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) initial assessment of the resources by the teachers, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers, 5) treatment claim assessment by the students, and 6) final assessment of the resources by the teachers. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. We will publish the study results in a peer-reviewed journal and in several Internet resources (web pages, electronic bulletins, and social media), and we will present them to the different users of interest in conferences, workshops, and meetings. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2020] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Nsangi A, Semakula D, Glenton C, Lewin S, Oxman AD, Oxman M, Rosenbaum S, Dahlgren A, Nyirazinyoye L, Kaseje M, Rose CJ, Fretheim A, Sewankambo NK. Informed health choices intervention to teach primary school children in low-income countries to assess claims about treatment effects: process evaluation. BMJ Open 2019; 9:e030787. [PMID: 31511291 PMCID: PMC6747654 DOI: 10.1136/bmjopen-2019-030787] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We developed the informed health choices (IHC) primary school resources to teach children how to assess the trustworthiness of claims about the effects of treatments. We evaluated these resources in a randomised trial in Uganda. This paper describes the process evaluation that we conducted alongside this trial. OBJECTIVES To identify factors affecting the implementation, impact and scaling up of the intervention; and potential adverse and beneficial effects of the intervention. METHODS All 85 teachers in the 60 schools in the intervention arm of the trial completed a questionnaire after each lesson and at the end of the term. We conducted structured classroom observations at all 60 schools. For interviews and focus groups, we purposively selected six schools. We interviewed district education officers, teachers, head teachers, children and their parents. We used a framework analysis approach to analyse the data. RESULTS Most of the participants liked the IHC resources and felt that the content was important. This motivated the teachers and contributed to positive attitudes. Although some teachers started out lacking confidence, many found that the children's enthusiasm for the lessons made them more confident. Nearly everyone interviewed thought that the children learnt something important and many thought that it improved their decision-making. The main barrier to scaling up use of the IHC resources that participants identified was the need to incorporate the lessons into the national curriculum. CONCLUSION The mostly positive findings reflect the trial results, which showed large effects on the children's and the teachers' critical appraisal skills. The main limitations of this evaluation are that the investigators were responsible for both developing and evaluating the intervention.
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Affiliation(s)
- Allen Nsangi
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Daniel Semakula
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Andrew D Oxman
- Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Astrid Dahlgren
- Regional Centre for Child and Adolescent Mental Health (Eastern and Southern Norway), Oslo, Norway
| | | | - Margaret Kaseje
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | | | - Atle Fretheim
- Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Nelson K Sewankambo
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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